Thirty Year Experience in Augmentation Rhinoplasty Using a Silicone Implant: A Safer, Cheaper, Faster, and More Effective Technique.

Background: The debate between alloplastic and autologous implant material for dorsal augmentation rhinoplasty continues among the aesthetic surgery community. Silicone implants are criticized for high rates of infection and extrusion; however, autologous methods increase the risk for warping and resorption, and donor-site deformity, which may affect positive outcomes.

Objectives: To demonstrate that silicone implants are a safe and reliable method of nasal augmentation when performed with proper technique, in an appropriate setting, and by qualified practitioners.

Methods: A retrospective chart review was conducted on 1019 patients who underwent implant rhinoplasty from February1995 to October 2024 by a single surgeon. All procedures were performed in a QuadA certified operating room under anesthesia by the senior author. I-shaped silicone implants were used for dorsal augmentation.

Results: The most common complication was due to malposition of the implant (n=37, 4%), subjective dissatisfaction was the leading reason for revision (n=43, 4%). Rates of extrusion and infection were low (n=9, <1%; n=4, <0.4%).

Conclusions: Compared to the current literature on silicone implant rhinoplasty, complications can be minimized with proper techniques, such as creating a precise subperiosteal pocket, selecting an appropriate implant length, and minimizing tension at the tip. Given this risk profile supports silicone implant augmentation rhinoplasty is a safe technique and should be considered for its benefits of shorter operation times, cost-effectiveness, and aesthetic outcomes especially in ethnic populations.